Codeine/paracetamol

Codeine/paracetamol, also called codeine/acetaminophen and co-codamol, is a compound analgesic, comprising codeine phosphate and paracetamol (acetaminophen). Codeine/paracetamol is used for the relief of mild to moderate pain when paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs; such as ibuprofen, aspirin, and naproxen) alone do not sufficiently relieve symptoms.

In 2021, it was the 176th most commonly prescribed medication in the United States, with more than 2million prescriptions.

Side effects
The most common side effects include constipation, nausea and drowsiness. Others include coughing up blood from the lungs, skin rashes, dizziness, sedation, shortness of breath, hypersensitivity reaction, fainting (syncope or near syncope), confusion, loss of short-term memory, changes in blood, allergic reactions, euphoria, dysphoria, abdominal pain, itchiness, easy bruising, bleeding gums, vivid dreams, dry mouth and addiction.

Genetic differences between people cause differing rates of metabolism of codeine to morphine. In about 5% of people this may happen particularly fast, causing morphine to be passed through breast milk in amounts that may cause fatal respiratory depression in a breastfed baby.

Availability
Of the European Union (EU) member states, 11 allow over-the-counter sale of solid dosage forms of codeine, including codeine/paracetamol; they are Bulgaria, Cyprus, Denmark, France, Ireland, Latvia, Lithuania, Malta, Poland, Romania and Slovenia.